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中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)和/或平均血小板体积(MPV)作为子痫前期的预测参数在临床上是否有用?

Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia?

作者信息

Mannaerts Dominique, Heyvaert Suzanne, De Cordt Chania, Macken Claartje, Loos Charlotte, Jacquemyn Yves

机构信息

a Department of Obstetrics and Gynecology , Antwerp University Hospital , Antwerp , Belgium.

b Anatomy and Research Centre, Research Group ASTARC, Antwerp Surgical Training, University of Antwerp , Antwerp , Belgium.

出版信息

J Matern Fetal Neonatal Med. 2019 May;32(9):1412-1419. doi: 10.1080/14767058.2017.1410701. Epub 2017 Dec 11.

Abstract

OBJECTIVE

Preeclampsia (PE) is a severe pregnancy complication with significant maternal and neonatal morbi-mortality resulting in high health care costs. Prevention, mainly based on the administration of acetylsalicylic acid, is only possible if timely identification of high-risk patients can be realized in an easy, nonexpensive, and widely available method. This paper explores the clinical usability of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) in discriminating between women that will and those that will not develop PE.

STUDY DESIGN

Demographic data and laboratory results were retrospectively collected and compared in 2050 pregnant women (164 PE and 1886 controls) between 1 January 2014 and 31 January 2016.

RESULTS

In the PE group, gravidity, parity, gestational age, and birth weight were significantly lower compared to the control group. Before the 20th pregnancy week, MPV was significantly elevated in the PE group compared to the controls (p = .006), hence analysis revealed an optimal cut-off point of 8.15 (sensitivity 66.7%, specificity 56.3%) for predicting PE. At the end of pregnancy, NLR and MPV appeared to be higher and PLR lower in the PE group compared to the controls, which strengthens the current knowledge on the pathogenesis of PE.

CONCLUSIONS

MPV is significantly elevated in the first half of pregnancy in women who later develop PE and might therefore be implemented in combination with other parameters in a PE prediction model.

摘要

目的

子痫前期(PE)是一种严重的妊娠并发症,会导致孕产妇和新生儿出现显著的发病和死亡情况,造成高昂的医疗费用。只有通过一种简便、经济且广泛可用的方法及时识别高危患者,才有可能实现以阿司匹林治疗为主的预防措施。本文探讨中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)和/或平均血小板体积(MPV)在鉴别将会发生和不会发生PE的女性中的临床实用性。

研究设计

回顾性收集并比较了2014年1月1日至2016年1月31日期间2050名孕妇(164例PE患者和1886例对照组)的人口统计学数据和实验室检查结果。

结果

与对照组相比,PE组的妊娠次数、产次、孕周和出生体重显著更低。在妊娠第20周之前,PE组的MPV相较于对照组显著升高(p = 0.006),因此分析显示预测PE的最佳截断值为8.15(敏感性66.7%,特异性56.3%)。在妊娠末期,与对照组相比,PE组的NLR和MPV似乎更高,而PLR更低,这强化了目前关于PE发病机制的认识。

结论

后来发生PE的女性在妊娠前半期MPV显著升高,因此可将其与其他参数结合应用于PE预测模型。

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